Abstract: The 2009 Cleveland Clinic Orthopaedic and Rheumatology Care - Quality Innovation Summit, May 13-15, 2009, is a 2 1/2 day multidisciplinary conference devoted to exploring the current state-of-the-art in the assessment and management of quality in Musculoskeletal Medicine from the perspective of each of the stakeholders in this process. Musculoskeletal disorders are the leading cause of disability in the United States, with one in every seven Americans afflicted with an impairment of the bones or joints. Each day, millions of Americans endure such conditions as osteoarthritis, rheumatoid arthritis, and osteoporosis, with the resulting pain, disability, and medical expense inflicting tremendous burdens on individuals, families, and society. Moreover, the impact of musculoskeletal conditions is expected to grow as the American population increases and ages in the coming decades. In response to this dramatic growth in patient populations and increase in the complexity of musculoskeletal diseases, the number of new drugs and devices, as well as therapeutic protocols to treat those diseases, has also increased. This evolution in treatment technologies has necessitated a new look at the methodology and metrics for measuring patient outcomes and patient satisfaction. This meeting is the first of its kind in orthopaedics and rheumatology, bringing together physicians, quality management specialists, public health professionals, information technology experts, government officials and patient safety advocates to address the "How and Why" of quality measurement.